目的探讨声带沟患者发声时最小声门面积(minimum glottal area, MGA)和嗓音声学指标的特征及相关性。方法选择60例正常人(正常组,男女各30例)和病理型声带沟患者62例(患者组,男33例,女29例)进行频闪喉镜检查,应用配套KIPS软件计算患者发/i:/音时的MGA;采用Dr.Speech声学分析软件测试其基频(FO)、基频微扰(jitter)、振幅微扰(shimmer)、标准化噪声能量(normalized noise energy, NNE)、谐噪比( harmony to noise ratio, HNR)、信噪比(signal noise ratio, SNR)、最长声时(maximum phonation time, MPT),并分别与发声时的MGA进行相关性分析。结果发/i:/音时,男性患者组MGA(434.74±112.83像素)明显大于男性正常组(298.25±93.63像素)(P%0.05);女性患者组MGA(484.75±143.91像素)明显大于女性正常组(293.43±93.73像素)(P〈0.05);男性及女性患者发声时MGA分别与基频(r=0.972,P〈0.05;r=0.928,P〈0.05)、基频微扰(r=0.978,P〈0.05;r=0.910,P〈0.05)、振幅微扰(r=0.973,P〈0.05;r=0.921,P〈0.05)、标准化噪声能量(r=0.883,P〈0.05;r=0.960,P〈0.05)呈正相关关系,与信噪比(r=-0.947,P〈0.05;r=-0.957,P〈0.05)、谐噪比(r=-0.959,P〈0.05;r=-0.944,P〈0.05)、最长声时(r=-0.891,P〈0.05;r=-0.936,P〈0.05)呈负相关关系。结论病理型声带沟患者发/i:/音时声门面积较正常人增大,其MGA值越大嗓音的SNR、HNR及MPT值越小,而F0、jitter、shimmer、NNE则随MGA值增大而增大。
Objective To investigate the voicing acoustic characteristics of sulcus vocalis patients with mini-mum glottal area(MGA). Methods 60 normal subjects (30 male,30 female), and 62 subjects with sulcus vocalis (33 male and 29 female)were recruited. They all had stroboscopic laryngoscopy,and had MGA measured when say-ing /i:/ using software supporting KIPS. The acoustic parameters consisted of vocal cord fundamental frequency (F0), litter and shimmer, normalized noise energy(NNE) ,harmony to noise ratio(HNR) and signal noise ratio (SNR), maximum phonation time(MPT) and respectively make correlation analysis with voice MGA. Results The voicing MGA of male patients with sulcus vocalis was 434.74 ±112.83, larger than the males with normal vocalis 298.25±93.53. This was statistically significant(P〈0.05). The voicing MGA of females with sulcus vocalis was (484.75±143.91),significantly larger than those of females with normal vocalis(293. 43±93. 73) and the differ-ence was statistically significant (P〈0.05). The voicing MGA on both males and females with suleus vocalis was noticeably relation to the FO (r=0. 972, P〈0.05) and (r=0. 928, P〈0.05), Jitter (r=0. 978, P〈0.05) and (r =0.910, P〈0. 910) and Shimmer (r=0. 973, P〈0.05) and (r=0. 921, P〈0.05), normalized noise energy(r= 0. 883, P〈0.05) and (r=0. 960, P〈0. 05) ; and negative relation to the signal noise ratio (r=-0. 947, P〈 0.05) and (r =-0. 957, P〈0.05), signal noise ratio (r=-0. 959, P〈0.05) and (r=-01 944, P〈0.05), max-imum phonation time (r=-0. 891, P〈0.05) and (r= -0. 936, P〈0.05). Conclusion Patients with pathological sulcus vocalis have glottal areas larger than normal. Acoustic analysis of the voices of the sulcus vocalis can be used as an objective laboratory examination.